# JOYCE C PECK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1427041037
- **Gender:** F

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 156FX1800X | Optician | 111468 | KY | Yes |

## Other

- **Enumeration date:** 08/30/2005
- **Last updated:** 01/31/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1063563104 | EMPLOYEE - IP | KY |
| 01 | — | 1093159626 | NPI-ADAM BRADLEY | KY |
| 05 | — | 5200015500 | — | KY |
| 01 | — | 60537045 | BLUE CROSS BLUE SHIELD | KY |
| 05 | — | 7100022560 | — | KY |